Individual provider Active NPI

Daniel Roy Charnstrom, DC

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1881623502
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5217 Issued in AZ
Practice address
20624 N Cave Creek Rd
Ste #140
Phoenix, AZ 85024-4453
Phone
(602) 788-7777
Fax
(602) 867-9185
NPI assigned
Jul 3, 2006
Last updated
Apr 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5217 AZ Primary

Addresses

Primary practice location

20624 N Cave Creek Rd
Ste #140
Phoenix, AZ 85024-4453

Mailing address

PO Box 71395
Phoenix, AZ 85050-1007
Phone (602) 788-7777

Other identifiers 1

IdentifierTypeStateIssuer
0930360OtherAZBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5217AZMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1881623502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71395",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850501007",
            "telephone_number": "602-788-7777",
            "fax_number": "602-867-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20624 N CAVE CREEK RD",
            "address_2": "STE #140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850244453",
            "telephone_number": "602-788-7777",
            "fax_number": "602-867-9185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARNSTROM",
        "first_name": "DANIEL",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0930360",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.